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Outpatient Prospective Payment System (OPPS)

IMPORTANT- CMS Press Release on 2002 Outpatient Update

On December 18, the Centers for Medicare & Medicaid Services (CMS) issued a press release announcing a decision to delay the effective date of the 2002 updates for the Outpatient Prospective Payment System (OPPS). The effect of this announcement is that CMS will process claims subject to the OPPS for dates of service of January 1, 2002, or later using the 2001 OPPS payment rates while CMS continues to review the rates and codes announced in November of this year. Claims for such services will be processed timely rather than holding such claims for three months as announced earlier.

The 12/18 press release is on the CMS Press Office web site, at http://www.cms.gov/media/press/press_release.asp?Counter=324

The Health Care Financing Administration has just placed two new program
memorandums on its web site that should be of interest to home health
agencies.

The first is Transmittal A-01-28, which is a clarification of a January
12, 2001, transmittal on Periodic Interim Payments, can be found at:

http://www.hcfa.gov/pubforms/transmit/A0128.pdf

The second is Transmittal A-01-30 and it applies to Regional Home Health
Intermediaries and provides further clarification regarding Advance
Beneficiary Notices and Demand Bills. This transmittal can be found at:

http://www.hcfa.gov/pubforms/transmit/A0130.pdf